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Tuesday, February 24, 2009

New Rules for How Medicare Pays Suppliers for Oxygen Equipment

Centers for Medicare and Medicaid Services announce changes in the way Medicare pays suppliers for Oxygen equipment. These changes take effect January 2009. You should be aware of the changes and how they inpact you.

The information provided below is from The Official U.S. Government Site for People with Medicare and is for informational purposes only.

"Previously, the law stated that you would own the oxygen equipment after you rented it for 36 months. Under the new law, the rental payments will end after 36 months, but the supplier continues to own the equipment. The new law thenrequires your supplier to provide the oxygen equipment and related supplies for 2 additional years (5 years total), as long as oxygen is still medically necessary.

The monthly rental payments to the supplier cover not only your oxygen equipment, but also any supplies and accessories such as tubing or a mouthpiece,oxygen contents, maintenance, servicing and repairs. Medicare pays 80% of therental amount, and the person with Medicare is responsible for any unpaid Part Bdeductible, and the remaining 20% of the rental amount. By the end of 36 months,total payments from Medicare and you to your supplier would be more than $7,000(based on rental payments of about $200 per month).

Your supplier has been paid over 36 months for furnishing your oxygen and oxygenequipment for up to 5 years, and your supplier is required to continue to maintainthe oxygen equipment (in good working order) and furnish the equipment and anynecessary supplies and accessories, as long as you need it until the 5 year period ends.If you use oxygen tanks or cylinders that need delivery of gaseous or liquid oxygencontents, Medicare will continue to pay each month for the delivery of contentsafter the 36-month rental period. The supplier that delivers this equipment to you inthe last month of the 36-month rental period must provide these items, as long as you medically need it, up to 5 years.

At the end of the 5-year period, your supplier’s obligation to continue furnishing youroxygen and oxygen equipment ends, and you may elect to obtain replacement equipment from any supplier. Your current supplier will probably alert you before the 5-year period is over so that you have time to decide whether to obtain the replacementequipment from them or from another enrolled supplier that you choose if you decide toswitch suppliers. A new 36-month payment period and 5-year supplier obligation periodstart once the old 5-year period ends and the new oxygen and oxygen equipment yourequire is furnished. All of the other rules described in this fact sheet apply to the replacement equipment and supplier of that equipment.

If your supplier is not following Medicare laws and rules, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. The customer service representatives will refer your case to the appropriate area.For more information about Medicare’s coverage of durable medical equipment, visitwww.medicare.gov/Publications/Pubs/pdf/11045.pdf to view "Medicare Coverage ofDurable Medical Equipment and Other Devices." You can also call 1-800-MEDICARE. "